Saving disaster-affected Australia’s mental health in a cost-effective way

A newly-released report from the Phoenix Australia team, Trauma experienced by Australian communities following a natural disaster: a preliminary economic assessment, highlights how a lack of a cohesive, proactive and cost-effective approach to treat the effects of this trauma suffered by millions of disaster-affected people, families and communities is bad for the country’s wellbeing and economy.

Supported by PriceWaterhouseCoopers (PwC) Australia, this report examines the estimated economic burden of unaddressed mental health consequences following bushfires, floods and cyclones and the benefits of reducing this terrible stress in our communities.

“The current approach to addressing recovery from natural disasters focuses more on the physical aspects than it does on mental health prevention”, said Professor David Forbes, director of Phoenix Australia. This approach results in a significant time delay in determining and implementing whatever mental health initiatives are subsequently provided.”

These impacts include post-traumatic stress disorder, depression, absenteeism and presenteeism, substance abuse, domestic violence and suicide. Mental health impacts can last up to 10 years, and the long-term effect is even higher. Professor Forbes said it is imperative for Australia to be prepared to fully support its citizens the next time disaster strikes the nation.

“Phoenix Australia recommends the development of a new collaborative national centre, with a focus on mental health, wellbeing and recovery programs in the context of disaster,” he said. “We believe this could potentially reduce the prevalence of mental health impacts following a disaster by up to 10 per cent — a conservative estimate.”

The implementation of an Australian-specific disaster model of’ assess and implement’ takes its learning from the UK’ screen and treat’ protocols to treat impacted communities following major disasters and threats but is much more comprehensive in treating the mental health consequence given the varying types of disasters experienced here in Australia, Professor Forbes said.

According to Nicole Sadler, associate professor at Phoenix Australia, the approaches that link evidence-based treatment with outreach and screening are known as ‘screen-and-treat’ or ‘outreach-and-screen’.

“The ‘screen and treat’ protocol is based on an initial period of ‘watchful waiting’ where most people exposed to a disaster will use natural coping mechanisms and social support to cope with mental health impacts,” she said. “After this initial period, screening is offered to people who are at high risk of developing mental health conditions. This model of care aims to assess and facilitate access to mental health services if the initial distress doesn’t resolve.”

For those with persistent distress, trauma-focused cognitive behavioural therapy (CBT) is recommended to help an individual come to terms with trauma through exposure to and emotional processing of memories of the event. “We know that trauma-focused CBT can reduce the risk of a PTSD diagnosis by almost half, compared to current treatment strategies.”

As an organisation, Phoenix Australia also intends to implement different programs to address the mental health impact of disasters – building resilience, increasing hope and optimism through education and training, providing disaster-related information and wellbeing guidance and up-skilling community leaders.

Our other programs will help to early identify, triage and treat those most at risk of developing long-term mental health symptoms following a disaster, and be able to continuously improve all processes.

“We want to ensure that we learn and refine interventions for future events in communities and provide disaster-related information and wellbeing guidance to improve mental health literacy,” Professor Forbes said. PwC Australia Partner and Health Economics & Policy Leader, Marty Jovic said most of the benefits start to outweigh their costs after four years and will bring in estimated net benefits of $18 million (cyclones), $23 million (bushfires) and $31 million (floods).

“Focusing on prevention shows that for every dollar invested, there are estimated returns of $1.20 (flood) to $1.40 (bushfire and cyclone) to governments, businesses and individuals in a year,” Mr Jovic said.